MDS Alert

Nurses who focus on MDS instead of floor work may still benefit from wearing scrubs.

Nurse assessment coordinators have different responsibilities in different organizations. While some are responsible only for the MDS and spend most of their time sequestered and handling the electronic paperwork, others are required to be on the floor from time to time or even regularly.

Unsurprisingly, different organizations have different policies on dress codes for administration or various nursing positions. While some require scrubs for all nursing staff, regardless of role, others allow or encourage business casual attire — or something else entirely, like regular use of lab coats. If you have leeway in your attire choices, consider the pros and cons of how residents, resident families or representatives, and colleagues see you, especially if your role as a nurse assessment coordinator is somewhat unique in your facility.

Note Various Functions of Clothing

Clothing has multiple functions — especially in the healthcare industry. An outfit choice provides a means of making a first impression, and can, for better or worse, serve as a way for others to evaluate your professionalism or even your knowledge about your job duties. While wearing business casual attire, like slacks and a button-down, you may signify to others that you work in a more officelike environment. Scrubs, on the other hand, have an almost universal symbolism as a connection to healing or caregiving. White coats hold a particular status in the public consciousness — maybe because of medical school white coat ceremonies — that the wearer is knowledgeable about medicine or science or research.

However, clothing’s usefulness as a signifier of status or roles can make things confusing in a healthcare facility like a nursing home, which employs many people of varying roles. If, for example, the facility requires all staff to wear scrubs, it can be hard for residents or visitors to figure out who is responsible for providing care and who works in other supportive roles. This kind of situation could be tough for the MDS nurse who needs to focus on assessments but can sometimes get roped into working on the floor providing more intensive nursing care.

“Identification of healthcare team members is challenging because multiple healthcare team members often wear similar scrub attire. This causes confusion not only for patients and their family members but for healthcare team members too. Patients, families, physicians, and other healthcare team members need to be able to identify who is providing care to the patient,” say Jennifer Sulanke, RN, nurse clinician, and Kevin Shimp, RN, nurse manager, at Virginia Commonwealth University Health System in Richmond, Virginia, in a 2015 article in the journal American Nurse Today.

Consider Incidental Exposure

An outfit choice is also a means of protection for the wearer. White coats can protect regular clothing from the messy realities of caregiving. However, white coats, which almost always have long sleeves, can actually transmit pathogens between patients (or, in this case, residents), particularly because they are not necessarily washed after every wear. Results from a 2010 study titled, “The potential for nosocomial infection transmission by white coats used by physicians in Nigeria: implications for improved patient-safety initiatives,” suggest that white coat sleeves harbor a measurable amount of antibiotic-resistant bacteria, and can actually cause people to get sick.

With many nursing facilities already struggling to control the spread of disease, curbing the use of white coats — or instituting a timely laundry policy — could help curb the spread of some infections. Even some jewelry can affect work in a nursing facility. Staff rings can accidentally cut residents, and watches or bracelets can cause an ergonomically uncomfortable hand placement on keyboards.

Bank on Colleague Solidarity

If you’d like to pursue a change in dress code at your facility, whether for yourself or your role or across the organization, get your colleagues involved.

Sulanke and Shimp, who helped change their hospital’s nursing dress code, say that focusing on and communicating evidence-based reasoning, keeping staff informed and involved in the decision-making surrounding the change, and providing a one-time stipend for new scrubs were all important factors in a successful change to nursing dress code rules.